Individual provider Active NPI

Jason Thomas Spaude, OD

  • Optometrist
  • Saint Joseph, MI
National Provider Identifier
1831889930
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005697 Issued in MI
Practice address
2603 Niles Ave Ste a
Saint Joseph, MI 49085-1954
Phone
(269) 408-8762
Fax
(269) 408-8764
NPI assigned
May 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005697 MI Primary

Addresses

Primary practice location

2603 Niles Ave Ste a
Saint Joseph, MI 49085-1954

Mailing address

2603 Niles Ave Ste a
Saint Joseph, MI 49085-1954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613000398 MI Practitioner - Optometry 1658738265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Center PCGroup PAC ID 9133176761, 2 clinicians

Practice addresses (Care Compare)

2603 Niles Ave
Suite a
Saint Joseph, MI 49085-1954
Phone (269) 408-8762

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Center PC Optometrist CurrentSince Jun 1, 2023 Accepting new patients

Locations

2603 Niles Ave
Ste A
Saint Joseph, MI 49085
Phone (269) 408-8762

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1831889930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 NILES AVE STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 NILES AVE STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851954",
            "telephone_number": "269-408-8762",
            "fax_number": "269-408-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAUDE",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-10-25",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.